Racial and gender disparities in care exist for patients newly-diagnosed with atrial fibrillation

3rd July 2015

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A new study published in HeartRhythm shows differences in the utilisation of atrial fibrillation therapies in the US population.

The largest-of-its-kind study proves race and gender-related disparities exist in care for patients who have recently been diagnosed with atrial fibrillation. The study, published in HeartRhythm includes data from more than 500,000 Medicare beneficiaries and notably finds that female patients compared to male patients are less likely to receive oral anticoagulation. Women are also less likely than men to receive an ablation, as were Hispanics versus whites.

The study found statistically significant differences in the use of atrial fibrillation-related services by both race and gender, with white patients and male patients receiving the most care. Specifically, women were less likely than men to receive anticoagulation (35% vs. 38.8%), and both blacks and Hispanics were less likely than whites (30.5% vs. 31.4% vs. 37.3%). Women were also less likely than men to receive an ablation (0.6% vs. 1.3%), as were Hispanics versus whites (0.6 vs. 0.9%). Hispanics and women were less likely to have an outpatient clinic visit with an electrophysiologist compared to their counterparts. Other differences were also seen in rate- and rhythm-controlling medications.

More than 500,000 (517,941) Medicare patients newly diagnosed with atrial fibrillation were compared using collective data from the Centers for Medicare and Medicaid during 2010–2011. The usage of medical services within 90 days of initial diagnosis was catalogued to determine any racial or gender differences. The services analysed included: visit to a cardiologist, visit to an electrophysiologist, and use of anticoagulation, rate-controlling medications, rhythm-controlling medications, or radiofrequency ablation.

“While we have seen racial and gender differences in the care of other cardiac conditions, our study is the first to broadly look at and show disparities in the receipt of care specifically for atrial fibrillation. Particularly, it was of concern to see that women were less likely to receive oral anticoagulation since they are at greater risk of stroke compared to men,” says Prashant Bhave, author of the study, (clinical assistant professor in the Department of Internal Medicine for University of Iowa Health Care, USA). “It is essential that each patient is treated with a consistent standard of care, regardless of race or gender. Increasing awareness about atrial fibrillation and effective therapy options is one step we need to take to help narrow this health equity gap.”

The study authors note that identifying patterns of disparity and barriers to care at the regional and local level may help to guide community-based interventions. Strategies to educate patients, change patterns of referral, and improve access to specialty care for women and minorities with atrial fibrillation may help to improve the quality of life and outcomes in those patients.